Monoplex PCRs is a molecular technique for amplification of a selected gene fragment of the genome of any organism or cell using a specific set of primers specifically designed for that purpose. These primers can recognize and anneal (bind) to their pre-determined (complimentary) sequence on the genome of that cell/organism. Then the reagents including the enzyme, buffers and the nucleotide mix (building blocks) are mixed together in proportion and put at temperature and conditions so that the enzyme can put the building blocks (nucleotides) in pre-specified sequence as per the complementarities to template (parent) strand of DNA.
Such monoplex PCR for diagnosing infections like Cytomegalo virus (CMV), Herpes simplex virus (HSV), Vericella zoster virus (VZV), Human Immunodeficiency virus (HIV), Toxoplasmosis gondii, Mycobacterium tuberculosis, Lyme disease and diseases like lymphomas and Whipple disease have been established. Thus, Monoplex PCR for any infection is known in the art. However, one major impediment to this technique is that one needs to perform a separate PCR reaction for each pathogen that could be time consuming and prohibitively expensive especially if one needs to test for a large number of potential pathogens. Also the monoplex examination would tax the available sample volume that might be very small in situation like intraocular samples.
Multiplex PCR assay is capable of screening various microbial organisms simultaneously or identify different alleles of one organism. In a multiplex PCR, a different cocktail of reagents is used for carrying all other ingredients of a reaction mix as in monoplex PCR situation in addition to the specifically designed primers for all the organisms which are to be identified or detected. However, in Multiplex PCR, the primers and the conditions that are applicable in a monoplex setting no longer produce same results because the primers for different organisms interfere with each other and reduce the sensitivity as well as specificity of assay. Thus both primer selection as well as optimization of conditions and concentration of reagents used need to be standardized, keeping in view the ‘nature’ of each and every primer as well as requirement of the sensitivity in that particular situation.
Dabil and coworkers have published earlier a technique of multiplex PCR assay, by using novel set of primers for a panel of common pathogens including CMV, HSV, VZV and Toxoplasma gondii (Ref: Dabil H, Boley M L, Schmitz T M and Van Gender R N. Validation of a diagnostic multiplex polymerase chain reaction assay for infectious posterior uveitis. Archieves of Opthalmol 2001; 119:1315-22). Persson and Oslen have published Multiplex PCR reaction for identification of Campylobacter Coli and Campylobacter jejuni from pure cultures and directly on stool samples (Persson S and Oslen K E. J Med Microbiol. 2005; 54:1043-7).